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Starting Treatment: Feel Dumb
Mar 11, 2005

Hi. I'm 32 living in the UK and I was diagnosed as having HIV three weeks ago. I've had my first blood results and my CD4 count is 232 and my viral load is 172,000. My consultant is recommending that I start treatment as soon as possible (which is freaking me out), and has suggested a combination of Efavirenz, Tenofovir and Lamivudine. I know about the possible side-effects of Efavirenz, but I'm still very worried that I'll be unable to carry on working. Also, my friend says that the Tenofovir and Lamivudine are available as a combined drug and is surprised that my consultant has not suggested this (Combovir?). I try and read sites like this, but don't feel like I fully understand it all. I'd appreciate some third party advice on the drugs that I'm being offered and what kind of difficulties I'm likely to face. Thanks.

Response from Dr. Young

Thanks for your post and question.

You're not dumb at all.

First off, I agree with your consultant that between your lower CD4 count and high viral load that starting on treatment is sound.

The combination of tenofovir + 3TC (lamivudine) and efavirenz (Sustiva/Stocrin) is a good one-- excellent clinical trials data on this have been presented. The combination pill that your friend is alluding to isn't Combivir (though that too is a well supported option), but Truvada (tenofovir+ FTC). To my understanding, Truvada has should be approved very soon (if not already) for use in the UK. Tenfovir + 3TC is not available as a combination pill, but 3TC and FTC appear to be very similar to one another and are thought to be relatively interchangable. Tenofovir/FTC with efavirenz have been studied in the Gilead 934 clinical trial (results can be reviewed in TheBody's conference coverage)-- data is very supportive of it's use and together can provide a 2 pill, once-daily first-line treatment.

Hope this helps, BY



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